Minutus

Dear Group,

I would like to initiate a discussion on potency and other dosing
considerations. I have studied homeopathy formally at two schools,
neither of which put much emphasis on potency. Often after a cured case
was presented by an instructor, a student would ask, "What potency did
you use?" and the reply would be, "I can't remember, probably 200c." We
were taught that determining the simillimum was paramount and potency
was of much less importance. The most common initial dose of a
constitutional remedy was 200c as dry pellets, and the number of pellets
of a dose was felt to be irrelevant.

I have since been in contact with practitioners who use primarily or
exclusively liquid dilutions of remedies, based on Hahnemann's
instructions in the 5th and 6th editions of the Organon. The theory is
that remedies are actually stronger when dissolved in water because,
according to Paragraph 272, "Each dose of it, however small, immediately
touches many nerve endings." In my limited experience, I have found that
dissolving pellets in water is extremely useful for highly sensitive
patients. However, for those of more average sensitivity, I am finding
that the C potencies administered as dry pellets seem to work more
rapidly and effectively.

I am interested to know other practitioners' approaches and experience
with potency, dry versus liquid doses, repetition of the dose, etc.
Thanks for any input.

Arlene

on 24/9/01 9:27 pm, Arlene Kellman, DO at akellman@qwest.net wrote:

Surely the potency should be as individual as the remedy? Regards, Joy Lucas
RSHom

Potency is all important when its all important.

For instance if you wish to support a liver in a very sick person the 10m
would not be the first choice more likely a 6.

If you need to see a reaction to confirm your choice of remedy then 200
is very helpful

Potency and repetition are often hotely discussed. My view is its more a
matter of clinical experience or what you leran how to use. Homeopathy
doesn't have these bounds its the homeopath.

Remedies can be repeated, various potencies can be used but as a
practitioner you need the clinical observation.

So set yourself a task of giving only the 30 potency for a month and see
what happens, or only the 200. Your result may be a lot of learning of
potency - it may be you find this can't be done and you can see an
expressed potency in the prescription more clearly. Both results are
useful.

Use these techniques as the basis of an audit to reflect on your
practice. If this doesn't make sense ask me more!

Len MArlow

Dear Arlene

A 'homeopathic' remedy only becomes Homeopathic when the patient has taken it and you can observe that it has started to act on the basis of symptom similarity.

The fact that it has been made by a homeopathic pharmacy or along homeopathic lines of remedy preparation does not make it homeopathic!

The most ideal homeopathic remedy for the patient is of course the Similimum which covers the totality of the symptoms.
That is to say a remedy that reflects most - if not all - of the significant symptoms exhibited by the patient's vital force.

One of the important aspects of this choice of remedy is not only its nature, but its potency which should match the patient's vitality.

In terms of analysing remedy reactions, George Vithulkas has interesting chapters (he rarely - if ever uses LMs). But simply, the concept of aggravation is only encountered when the potency is thought to be higher than the pt's vitality. But taking into consideration Hn's instructions that cure MUST be gentle, then we must look at methods that cause the minimum aggravation and discomfort to the patient.

Hn did a lot of experimentation and had Org 6 been published during his life time I would very much doubt if many people would now use 30, 200 1m etc potencies.

Hn calls LM potencies his 'perfected' method.

They are so easy to administer. You can give it to the patient while they are taking allopathic drugs and it gives you a gentle opportunity to wean the patient off the allopathic drugs (always liaiase with their allopath). These patients are also used to taking allopathic drugs on a daily basis so giving them LM potencies on a daily basis helps them psychologically.

Also because you can give it as often as necessary, if the patient inadvertently does something to antidotes the remedy, the next dose would restore the situation.

Especially in cases of skin trouble, asthma or other situations where patient physical discomfort is of great importance, LM potencies are invaluable and will take care of the situation. You can also stop the rx action fairly quickly.

For most chronic cases, I use LM potencies and the patient soon learns how often to use it. Some may need to use it three/four times a day while others may use it once every three months.
(Don't forget that we are after the minimum dose, so the less the better!!)

The policy that works well is to give one dose of LM01 and wait 3-4 days.
See how the reaction is progressing. If improvement is progressing, do not repeat until progress starts to dip.
(You do not try to push a car that is running - do you?)

Soon a pattern develops that you notice say every 5 days the pt is reporting that he is not as well as the day before.
So the best policy is to repeat every 4 days, so the patient goes from one gentle peak to another to reach max health possible for him.

LMs can be used as effectively in acutes, however, you may need to repeat often.

In fevers I would prefer to use high potency (again you need to repeat often) and the best plan is to use the plussing method - that is to drop a 30 or 200 pill in a bottle of water (say 200-250 ml) and before each dose the bottle should be succussed about 1o times.
(Kent: No two doses should be of the same potency).

This works well and gives you a result rapidly.
You may repeat every few minutes if necessary!

=======
Case:
Just before Xmas 1998 we had a flu epidemic in UK during which many thousands where hospitalised and about 2500 died of it. This male 50 years old patient rapidly fell ill and the depth of his illness was so much that he was not able to think clearly or to call for help (Hom or Allopathy) in the early stages.

Severe painful cough to the degree that he had to sit to cough, while holding his ribs tightly as his ribs were very painful - as if broken.

He receives no help from any quarter for five days.
On sixth day he wakes early in the morning with a very high pulse and breathing rates.
Bubbling noise from his lungs. Must sit upright otherwise coughs. Any other position and he would cough immediately.

He panics that he has pneumonia - will end up in hospital and at this pulse rate his heart would soon give in.

HELP!!!

The indicated remedy Ant-t was prescribed to him at 200c in water.
After the first and second dose nothing happened (15 minutes apart).
(Homeopath now wondering whether the choice of rx was correct!)
Within 1 minute of taking the third dose he reports that the flow at the back of his throat has stopped - as if someone turned off a tap. He lies back and there is no cough.
He rests his head on the pillow and sleeps soundly for 8 hours.

The recovery has started. Follow up remedies of Bry and Ars finished the case off.
=======

If you do not have access to LM remedies, then my suggestion is to judge your pt's vitality and aim at that. Do not go higher than necessary. It is easier to go up in potency than to come down. So start with 30 if you can.
Also Kent reports a lot of agg with 200c.

In a mechanical analogy, if pushing by hand will get you where you need to go in a short time, is there a need to use a tow rope?

So to sum up: The Similimum is a mix choice of the nature of the remedy and its potency.

Good healing
Soroush

Dear Arlene,

It is really true that many homeopaths do not consider
'potency' and esp 'dose' as important factors in their
prescriptions.

Another point is that the definition of the two terms
DOSE and POTENCY are different in Hahnemannian
terminology. 'Potency' shows the degree of
dynamization but 'dose' refers to the amount of the
remedy. 'Potency' is a quality but 'dose' indicates a
quantity.

It is worth noting that in Kentian posology, dose and
potency are not considered as different terms. Kent
did not believe in quantitative factors regarding
homeopathic remedies, which is in contrast to
Hahnemann's teachings where quantity is also of major
(and even much more) importance.

Medicinal solutions acquire good potential for
stimulating the Vital Force. Here the dose adjustment
becomes very important. One teaspoon of the solution
is different than 2 teaspoons. Sometimes it is
necessary to dilute the medicinal solution, in a
serial manner, 5 to 6 times, in order to reduce the
risk of a severe aggravation. Hahnemann's Organon
clearly reflects these facts in different aphorisms.

Dose adjustment becomes much more important in
sensitive cases and specially when a well-chosen
simillimum is prescribed. Hahnemann warns us,'For this
reason, a medicine, even though it may be
homoeopathically suited to the case of disease, does
harm in every dose that is too large, and in strong
doses it does more harm the greater its
homoeopathicity and the higher the potency selected,
and it does much more injury than any equally large
dose of a medicine that is unhomooepathic and in no
respect adapted to the morbid state (allopathic).'
(Organon of Medicine, ver 6, aph 276'

Two groups of homeopaths do not encounter severe
aggravations following their precriptions. First,
those who prescribe partial simillimums or remedies
unhomeopathically related to patient's state and
second, those who prescribe simillimums but carefully
adjust the dose and potency.

Medicinal solutions can be repeated with much more
frequency than dry doses. We should be careful in
repetition of the doses without changing the degree of
dynamization.

In aphorism 247 of Organon, Samuel Hahnemann writes:
'It is impractical to repeat the same unchanged dose
of a remedy once, not to mention its frequent
repetition (and at short intervals in order not to
delay the cure). The vital principle does not accept
such unchanged doses without resistance, that is,
without other symptoms of the medicine to manifest
themselves than those similar to the disease to be
cured, because the former dose has already
accomplished the expected change in the vital
principle and a second dynamically wholly similar,
unchanged dose of the same medicine no longer finds,
therfore, the same conditions of the vital force. The
patient may indeed be made sick in another way by
receiving other such unchanged doses, even sicker than
he was, for now only those symptoms of the given
remedyremain active which were not homoeopathic to the
original disease, hence no step towards cure can
follow, only a true aggravation of the condition of
the patient. But if the succeeding dose is changed
slightly every time, namely potentized somewhat higher
(aphorisms 269-270) then the vital principle may be
altered without difficulty by the same medicine (the
sensation of natural disease diminishing) and thus the
cure brought nearer.'

Also he writes, 'We ought not even with the best
chosen homoeopathic medicine, for instance one pellet
of the same potency that was beneficial at first, to
let the patient have a second or third dose, taken
dry......'(Organon, footnote 133)

I myself applied different modes of remedy
administration in hundreds of cases. Now I really
believe in Hahnemannian posology. With Hahnemannian
posology I have really less problems in aggravation
management and follow-ups.

David Little, the brilliant American homeopath now
living in Himalaya, has written several wonderful
articles on this subject. Visit his website with his
great library at http://www.simillimum.com

Best,

Ardavan
--- "Arlene Kellman, DO" wrote:

=====
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Dear Arlene, and other members
Potency and dose is a very confusing subject in Homeopathy.
Lately is stumbled on a suprising article:
Potency Precision-A Breakthrough ---by Dr L G K Moorthy - Banganga Society,
Govandi, Mumbai.India
http://www.neuindia.com
I like to know the reaction of the other members.
I read a lot about the potency problem, and I think this is a very inspiring
en promising aproach.

Piet Guijt